Choosing the Right Lens Power for Cataract Surgery with One Eye Left

Q: Choosing the Right Lens Power for Cataract Surgery with One Eye Left

Hello： You have two options to choose from based on your needs： 1. <br>According to your ophthalmologist's recommendation, after surgery on your left eye, you will have no prescription, allowing you to see far without glasses, while you can wear reading glasses for near vision. <

I would like to inquire about the choice of lens power for cataract surgery in a patient with only one functioning eye?

Dear Director Gao,
A few years ago, I underwent surgery for a retinal detachment in my right eye, during which an artificial intraocular lens was implanted.
The surgeon initially left me with a prescription for -3.00 diopters of myopia without presbyopia.
However, after the surgery, I can only see vague images with my right eye and cannot discern details; I can only see the large "E" on the vision chart.
This year, my left eye has developed severe cataracts, and I need cataract surgery.
Due to financial constraints, I can only opt for a single-focus intraocular lens covered by health insurance.
However, the doctor's recommendation is to have no myopia correction and just use reading glasses for presbyopia.
I do not quite understand this; wouldn't that create a disparity of 3.00 diopters between my two eyes again?
I primarily ride a scooter to work, use a computer at my job, and read small print on scratch-off lottery tickets from about 60 centimeters away, as well as operate a lottery betting machine.
Should I choose a lens with the same -3.00 diopter correction as my right eye to maintain balance, or should I follow the doctor's advice and just use reading glasses without myopia correction?
Additionally, I would like to inquire whether my myopia and presbyopia could continue to worsen after cataract surgery, or if they will stabilize.
I am currently only 50 years old and have only one functional eye left, so I hope to receive good advice from the doctor.
Thank you.

A Sheng, 50~59 year old female. Ask Date: 2023/12/27

Dr. Gao Pilin reply Ophthalmology

Hello: You have two options to choose from based on your needs: 1.
According to your ophthalmologist's recommendation, after surgery on your left eye, you will have no prescription, allowing you to see far without glasses, while you can wear reading glasses for near vision.
Although there is a 300-degree difference compared to your right eye, it should not significantly affect your daily life due to the poor vision in your right eye.
2.
You can choose to maintain a myopia of 300 degrees in your left eye, which means you will need to wear glasses for distance vision, but you won't need reading glasses for near vision.
Both options are viable, and you can choose based on your lifestyle habits.

Reply Date: 2023/12/27

More Info

Choosing the right lens power for cataract surgery, especially when you have one eye that has already undergone surgery, is a critical decision that can significantly impact your quality of life. In your case, you have a history of retinal detachment surgery in your right eye, which has left you with limited vision, and now you are facing cataract surgery in your left eye.
Firstly, let’s address the recommendation from your doctor regarding the choice of lens power. The suggestion to use a lens that does not correct for myopia (nearsightedness) and instead requires reading glasses for presbyopia (age-related difficulty in seeing close objects) is based on a few considerations. One of the primary goals of cataract surgery is to optimize your vision for your daily activities. Since you mentioned that you primarily use your left eye for tasks like riding a motorcycle and using a computer, it is essential to consider what distance you need to see clearly.

If your right eye has a residual myopia of -3.00 diopters and you are considering a lens for your left eye that does not correct for myopia, this will indeed create a significant disparity between the two eyes. This disparity could lead to visual discomfort, especially when using both eyes together. The brain typically prefers to use the eye that provides the clearest image, which in your case may lead to reliance on the left eye, potentially causing further issues with depth perception and overall visual comfort.

Given your daily activities, it might be more beneficial to choose a lens power for your left eye that balances with your right eye's prescription. This means opting for a lens that corrects for the -3.00 diopters of myopia. This would allow you to have a more uniform visual experience when using both eyes, which is crucial for tasks that require depth perception and clarity, such as riding a motorcycle or reading small print.

Regarding your concern about whether your vision will continue to change after cataract surgery, it is important to understand that while cataract surgery can significantly improve your vision, it does not prevent the natural aging process of the eye. After surgery, it is possible for your eyes to develop new refractive errors, such as worsening myopia or presbyopia, as you age. However, the degree to which this occurs can vary widely among individuals. Regular eye examinations after surgery will help monitor any changes in your vision and allow for timely interventions, such as new glasses if necessary.

In conclusion, considering your specific visual needs and the significant difference in lens power between your two eyes, it may be wise to discuss with your ophthalmologist the possibility of selecting a lens for your left eye that corrects for myopia. This approach could provide you with a more balanced visual experience, enhancing your ability to perform daily tasks comfortably. Always ensure that you have a thorough discussion with your eye care provider about your lifestyle, visual needs, and any concerns you may have regarding the surgery and post-operative vision changes.

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